摘要
目的评估会阴无保护分娩技术对初产妇分娩结局及产后盆底功能的影响。方法回顾性分析2016年10月至2018年12月在北京大学深圳医院产科行会阴无保护分娩初产妇500例的临床资料,并选择同期传统的会阴保护分娩初产妇500例作为对照组,比较两组分娩结局及盆底功能情况。结果①研究组和对照组会阴裂伤率(59.0%,295/500;54.6%,273/500)比较,差异无统计学意义(P>0.05);研究组会阴侧切率(26.6%,133/500)低于对照组(37.2%,186/500),而会阴完整率(14.4%,72/500)高于对照组(8.2%,41/500),两组比较,差异均有统计学意义(P <0.05)。②研究组产后Ⅱ类肌纤维肌力[(1.85±0.96)级]高于对照组(1.69±1.00)级,差异有统计学意义(P <0.05),而两组产后Ⅰ类肌纤维肌力及POP-Q评分比较,差异均无统计学意义(P>0.05)。③研究组产后尿潴留发生率(2.4%,12/500)低于对照组(4.8%,24/500),差异有统计学意义(P <0.05)。结论会阴无保护分娩技术可减少会阴侧切率,改善产后尿潴留和盆底肌力,值得临床推广。
Objective To evaluate the impact of "hands off" techniques on the delivery outcome and postpartum pelvic floor function of primipara. Methods This study was a retrospective study. 500 primipara with "hands off" techniques were included as the study group from October, 2016 to December, 2018, and 500 primipara with "hands on" techniques were used as the control group. The neonatal condition, delivery outcome and pelvic floor function were compared between the two groups. Results ① There was no significant difference of perineal laceration(59.0%, 295/500 vs 54.6%, 273/500) between the two groups(P > 0.05), but the rate of episiotomy was significantly lower in the study group than in the control group [26.6%(133/500) vs 37.2%(186/500)],while the rate of perineal integrity was higher than in the control group [14.4%(72/500 vs 8.2%(41/500)], all differences were statistically significant(P < 0.05). ② The muscle strength of type II myofibers in the study group was higher than that in the control group(1.85±0.96 vs 1.69±1.00), and the difference was statistically significant(P < 0.05). The differences in postnatal muscle strength of type I myofibers and POP-Q score between the two groups were not statistically significant(P > 0.05). ③ The incidence of postpartum urinary retention was lower in the study group than in the control group [2.4%(12/500) vs 4.8%(24/500)], and the difference was statistically significant(P < 0.05). Conclusion The "hands off" technique has certain advantages in effectively improve postpartum urinary retention and reduce the damage of pelvic floor function.
作者
潘映红
胡艳
陈晓霞
张巍颖
蒋娜
许青
欧锦屏
PAN Yinghong;HU Yan;CHEN Xiaoxia;ZHANG Weiying;JIANG Na;XU Qing;OU Jinping(Department of gynecology,Peking University Shenzhen Hospital,Shenzhen Guangdong 518036,China)
出处
《中国妇产科临床杂志》
CSCD
北大核心
2020年第6期606-608,共3页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
深圳市医疗卫生三名工程(SZSM201512034)
深圳市医学重点学科建设经费资助(SZXK027)。
